Five point challenge to all political parties, setting out how to improve the NHS

A five point challenge to all political parties, setting out how to improve the NHS, is published today (Tuesday 8 March 2005) by the British Medical Association. "A vote to improve health" takes the form of a doctors' manifesto for the forthcoming general election.

BMA Chairman, Mr James Johnson, is sending the document to the leaders of the main political parties calling on them to address the challenges to visibly improve the health service. He said: "The NHS is not as good as it could be. Doctors share many of the parties' stated aims to improve it. But if goals such as shortening waiting times and making care more patient-centred are to become reality, politicians have to face a number of challenges."

The challenges are:

Improve public health, helping people to lead healthier lives "Gross health inequalities still exist in the UK with intolerable differences in health status between groups. The incoming government must provide a more coherent public health policy and make it a clear national priority" said Mr Johnson.

Make patient choice meaningful and relevant to patients "Choice cannot be delivered simply by buying in more private provision or introducing a market where providers compete for referrals" says the BMA manifesto. Patient choice should not be skewed by spurious targets relating to the level of private-provider use. "Doctors worry that choice appears to be little more than a euphemism for increased private involvement in healthcare and competition between institutions that provide care."

Recognise the limits to the role the private sector can play and strengthen the NHS Current policies are in danger of relocating capacity instead of adding to it, says the BMA. The manifesto states: "Diverting investment from the NHS to the private sector will do little to solve the problems of the NHS and in the long term may worsen them by damaging mainstream healthcare". The BMA believes the market in health care should have clear limits and operate on a level playing field.

Involve doctors, patients and the public in the formulation of policy and reform initiatives Failure to involve doctors, patients and the public in health policies can produce results that are "impractical to implement, miss out some vital aspect of patients' interests or are not supported by doctors." The BMA says an example of this failure lies within the National Programme for IT, the £6bn project for the NHS.

Invest in doctors to enable them to lead improvement across the NHS Doctors are at the core of treating patients, improving their care and providing education. "The medical profession must be valued, further invested in and freed from political interference to work with (others) to improve care across the NHS" says the manifesto.

The UK's supply of doctors does not match demand, says the BMA and we rely heavily on overseas trained medics. The manifesto calls for self sufficiency in doctors and nurses and says: "It seems iniquitous that wealthy, developed, English-speaking nations like the UK and USA should be draining poorer countries of scarce medical manpower."

Ways to invest in doctors include:

• Protecting academic medicine and widening access to medical schools
• Making sure plans for junior doctors' training are feasible in practice
• Providing round the clock childcare to match the hours NHS staff work
• Improve the working conditions of staff and associate specialist doctors
• Recognise the value of GPs as being at the centre of primary care
• Provide a new deal for GPs working in community hospitals
• The NHS Pension Schemes should not be reduced in value.

Doctors all over the UK will be using the BMA Manifesto to challenge their local MPs and prospective parliamentary candidates in the run up to the general election.